Bryan Nicholas, Ashwin Helen, Smart Neil J, Wohlert Stephen, Bayon Yves, Hunt John A
1 Clinical Engineering (UKCTE), The Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool - UK.
J Appl Biomater Funct Mater. 2015 Mar 18;13(1):35-42. doi: 10.5301/jabfm.5000172.
Hernia repair often involves fascial augmentation using biologic prostheses. Small processing changes during preparation modulate host tissue response, which influence material efficacy and longevity. In this pilot study, a rat model was used to determine the specific influence of tissue origin, decellularisation treatment and 1,6-hexamethylene diisocyanate (HMDI) cross-linking.
Materials (1 cm2) were implanted subcutaneously into 6-week-old Wistar rats (4 materials per animal, n=6/material per time point) for 2, 5, 7, 14 and 28 days. Histologic processing was carried out after resin infiltration, observing classical histopathology and pathologic indexing. Materials comprised 6 tissue-based grafts covering both experimental and commercial porcine decellularised dermal and small intestinal submucosal materials.
Subcutaneous delivery of biologics demonstrated material-specific inflammatory/host responses. Controlled variations of the PermacolTM manufacturing process showed sodium dodecyl sulfate (SDS) was the most proinflammatory decellularisation reagent, and HMDI cross-linking had no effect on host response. All materials remained recoverable after 28 days, although SurgisisTM had partially resorbed.
Differences in host responses exist between biologic implants for hernia repair in this rat model. It is postulated that these modifications are induced during processing and may have an effect on the clinical outcome of hernia repair.
疝修补术通常涉及使用生物假体进行筋膜增强。制备过程中的微小工艺变化会调节宿主组织反应，进而影响材料的功效和使用寿命。在这项前瞻性研究中，使用大鼠模型来确定组织来源、脱细胞处理和1,6 - 六亚甲基二异氰酸酯（HMDI）交联的具体影响。
将材料（1平方厘米）皮下植入6周龄的Wistar大鼠体内（每只动物植入4种材料，每个时间点每种材料n = 6只），分别植入2、5、7、14和28天。树脂浸润后进行组织学处理，观察经典组织病理学和病理指标。材料包括6种基于组织的移植物，涵盖实验用和商用猪脱细胞真皮及小肠黏膜下层材料。
生物材料的皮下递送显示出材料特异性的炎症/宿主反应。PermacolTM制造工艺的可控变化表明，十二烷基硫酸钠（SDS）是最具促炎作用的脱细胞试剂，而HMDI交联对宿主反应没有影响。尽管SurgisisTM已部分吸收，但所有材料在28天后仍可回收。
在这个大鼠模型中，用于疝修补的生物植入物之间存在宿主反应差异。据推测，这些改变是在加工过程中诱导产生的，可能会对疝修补的临床结果产生影响。
